Emanuela Concetta D'Angelo1, Pasquale Paolisso1, Giovanni Vitale1, Alberto Foà1, Luca Bergamaschi1, Ilenia Magnani1, Giulia Saturi1, Andrea Rinaldi1, Sebastiano Toniolo1, Matteo Renzulli2, Domenico Attinà3, Luigi Lovato3, Giacomo Maria Lima4, Rachele Bonfiglioli4, Stefano Fanti4, Ornella Leone5, Maristella Saponara6, Maria Abbondanza Pantaleo6, Paola Rucci7, Luca Di Marco8, Davide Pacini8, Carmine Pizzi9, Nazzareno Galiè1. 1. Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy. 2. Radiology Unit, Department of Experimental, Diagnostic and Specialty Medicine, Sant'Orsola Hospital, University of Bologna, Bologna, Italy. 3. Radiology Unit, Cardio-Thoracic-Vascular Department, Sant'Orsola Malpighi Hospital, University of Bologna, Bologna, Italy. 4. Institute of Nuclear Medicine, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy. 5. Department of Pathology, University of Bologna, Azienda Ospedaliera S. Orsola-Malpighi of Bologna, Italy. 6. Department of Specialized, Experimental and Diagnostic Medicine, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. 7. Division of Hygiene and Biostatistics, Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy. 8. Cardiac Surgery Unit, Cardio-Thoracic-Vascular Department, Sant'Orsola Hospital, Alma Mater Studiorum, University of Bologna, Bologna, Italy. 9. Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy. Electronic address: carmine.pizzi@unibo.it.
Abstract
OBJECTIVES: This study sought to assess the diagnostic accuracy of cardiac computed tomography (CT) and 18F-fluorodeoxyglucose (18F-FDG) with positron emission tomography/computed tomography (PET/CT) in defining the nature of cardiac masses. BACKGROUND: The diagnostic accuracy of cardiac CT and 18F-FDG PET/CT in identifying the nature of cardiac masses has been analyzed to date only in small samples. METHODS: Of 223 patients with echocardiographically diagnosed cardiac masses, a cohort of 60 cases who underwent cardiac CT and 18F-FDG PET/CT was selected. All masses had histological confirmation, except for a minority of thrombotic formations. For each mass, 8 morphological CT signs, standardized uptake value (SUVmax, SUVmean), metabolic tumor volume, and total lesion glycolysis in 18F-FDG PET were used as diagnostic markers. RESULTS: Irregular tumor margins, pericardial effusion, invasion, solid nature, mass diameter, CT contrast uptake, and pre-contrast characteristics were strongly associated with the malignant nature of masses. The coexistence of at least 5 CT signs perfectly identified malignant masses, whereas the detection of 3 or 4 CT signs did not accurately discriminate the masses' nature. The mean SUVmax, SUVmean, metabolic tumor volume, and total lesion glycolysis values were significantly higher in malignant than in benign masses. The diagnostic accuracy of SUV, metabolic tumor volume, and total lesion glycolysis 18F-FDG PET/CT parameters was excellent in detecting malignant masses. Among patients with 3 or 4 pathological CT signs, the presence of at least 1 abnormal 18F-FDG PET/CT parameter significantly increased the identification of malignancies. CONCLUSIONS: Cardiac CT is a powerful tool to diagnose cardiac masses as the number of abnormal signs was found to correlate with the lesions' nature. Similarly, 18F-FDG PET/CT accurately identified malignant masses and contributed with additional valuable information in diagnostic uncertainties after cardiac CT. These imaging tools should be performed in specific clinical settings such as involvement of great vessels or for disease-staging purposes.
OBJECTIVES: This study sought to assess the diagnostic accuracy of cardiac computed tomography (CT) and 18F-fluorodeoxyglucose (18F-FDG) with positron emission tomography/computed tomography (PET/CT) in defining the nature of cardiac masses. BACKGROUND: The diagnostic accuracy of cardiac CT and 18F-FDG PET/CT in identifying the nature of cardiac masses has been analyzed to date only in small samples. METHODS: Of 223 patients with echocardiographically diagnosed cardiac masses, a cohort of 60 cases who underwent cardiac CT and 18F-FDG PET/CT was selected. All masses had histological confirmation, except for a minority of thrombotic formations. For each mass, 8 morphological CT signs, standardized uptake value (SUVmax, SUVmean), metabolic tumor volume, and total lesion glycolysis in 18F-FDG PET were used as diagnostic markers. RESULTS: Irregular tumor margins, pericardial effusion, invasion, solid nature, mass diameter, CT contrast uptake, and pre-contrast characteristics were strongly associated with the malignant nature of masses. The coexistence of at least 5 CT signs perfectly identified malignant masses, whereas the detection of 3 or 4 CT signs did not accurately discriminate the masses' nature. The mean SUVmax, SUVmean, metabolic tumor volume, and total lesion glycolysis values were significantly higher in malignant than in benign masses. The diagnostic accuracy of SUV, metabolic tumor volume, and total lesion glycolysis 18F-FDG PET/CT parameters was excellent in detecting malignant masses. Among patients with 3 or 4 pathological CT signs, the presence of at least 1 abnormal 18F-FDG PET/CT parameter significantly increased the identification of malignancies. CONCLUSIONS: Cardiac CT is a powerful tool to diagnose cardiac masses as the number of abnormal signs was found to correlate with the lesions' nature. Similarly, 18F-FDG PET/CT accurately identified malignant masses and contributed with additional valuable information in diagnostic uncertainties after cardiac CT. These imaging tools should be performed in specific clinical settings such as involvement of great vessels or for disease-staging purposes.
Authors: Ayaz Aghayev; Michael K Cheezum; Michael L Steigner; Negareh Mousavi; Robert Padera; Ana Barac; Raymond Y Kwong; Marcelo F Di Carli; Ron Blankstein Journal: J Nucl Cardiol Date: 2021-09-02 Impact factor: 3.872
Authors: Juan C Lopez-Mattei; Eric H Yang; Maros Ferencik; Lauren A Baldassarre; Susan Dent; Matthew J Budoff Journal: JACC CardioOncol Date: 2021-12-21
Authors: Lorenzo Bartoli; Francesco Angeli; Andrea Stefanizzi; Michele Fabrizio; Pasquale Paolisso; Luca Bergamaschi; Alessandro Broccoli; Pier Luigi Zinzani; Nazzareno Galiè; Paola Rucci; Alberto Foà; Carmine Pizzi Journal: Front Cardiovasc Med Date: 2022-08-11